Introduction of Lifetime Community Rating (LCR) to the Private Health Insurance Market – FAQ

Community rating is a fundamental cornerstone of the Irish health insurance system. Under community rating, the level of risk that a particular consumer poses to an insurer does not directly affect the premium paid. This means that people who are old or sick do not have to pay more for the same insurance plan than the young and healthy. Insurers are also required to accept all applicants for health insurance, regardless of their health status or age.
For community rating to work we depend on adequate numbers of younger people taking out health insurance to help keep premium prices down for everybody. Lifetime community rating, which came into operation on 1 May 2015,  modifies community rating so that the premium that individuals pay for health insurance increases with the age at which they enter the health insurance market. Late entry loadings now apply for people aged 35 and over when taking out health insurance for the first time. The loadings are set at 2% per year starting at age 35, up to a maximum loading of 70% at age 69 and over.

There are credits available for (i) persons who had health insurance cover and (ii) individuals who previously had health insurance but stopped cover since January 2008 because of unemployment (this credit not exceeding 3 years in total). The level of loading will be reduced by the relevant credit period(s).

Lifetime community rating encourages people to take out health insurance at a younger age, thereby helping to spread the health costs of older and less healthy people across all insured persons. It is a necessary measure to help support the viability of community rating within our system of health insurance.

Frequently Asked Questions

Additional information can be found on the Health Insurance Authority website which includes an LCR calculator which should provide a useful estimate of the level of loading that may apply